Abstract:
CONTEXT:Attrition is common in longitudinal observational studies in palliative care. Few studies have examined predictors of attrition. OBJECTIVES:To identify patient characteristics at enrollment associated with attrition in palliative oncology outpatient setting. METHODS:In this longitudinal observational study, advanced cancer patients enrolled in an outpatient multicenter study were assessed at baseline and two to five weeks later. We compared baseline characteristics between patients who returned for follow-up and those who dropped out. RESULTS:Seven hundred forty-four patients were enrolled from Jordan, Brazil, Chile, Korea, and India. Attrition rate was 33%, with variation among countries (22%-39%; P = 0.023). In univariate analysis, baseline predictors for attrition were cognitive failure (odds ratio [OR] 1.23 per point in Memorial Delirium Assessment Scale; P < 0.01), functional status (OR 1.55 per 10-point decrease in Karnofsky Performance Status; P < 0.01), Edmonton Symptom Assessment Scale [ESAS] physical score (OR 1.03 per point; P < 0.01), ESAS emotional score (OR 1.05 per point; P < 0.01), and shorter duration between cancer diagnosis and palliative care referral in months (OR 0.89 per log; P = 0.028). In multivariate analysis, cognitive failure (OR 1.12 per point; P = 0.007), ESAS physical score (OR 1.18 per point; P = 0.027), functional status (OR 1.35 per 10-point decrease; P < 0.001), and shorter duration from cancer diagnosis (OR 0.86 per log; P = 0.01) remained independent predictors of attrition. CONCLUSION:Advanced cancer patients with cognitive failure, increased physical symptoms, poorer performance status, and shorter duration from cancer diagnosis were more likely to dropout. These results have implications for research design, patient selection, and data interpretation in longitudinal observational studies.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Perez-Cruz PE,Shamieh O,Paiva CE,Kwon JH,Muckaden MA,Bruera E,Hui Ddoi
10.1016/j.jpainsymman.2017.11.009subject
Has Abstractpub_date
2018-03-01 00:00:00pages
938-945issue
3eissn
0885-3924issn
1873-6513pii
S0885-3924(17)30640-1journal_volume
55pub_type
杂志文章,多中心研究abstract::The rising prevalence of neuropathic pain and the multifaceted sequelae of pain particularly within older adults are part of the increasing challenges in providing good geriatric pain management. Aging can lead to a higher sensitivity to pain within older adults, whereas physiological changes modify the absorption, bi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2009.05.002
更新日期:2009-08-01 00:00:00
abstract::Despite decades of research, national mandates, and widespread implementation of guidelines, recent reports suggest that the quality of pain assessment and management in hospitalized children remains suboptimal. The mismatch between what is advocated and what is done in practice has led experts to argue for a conceptu...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2011.09.005
更新日期:2012-09-01 00:00:00
abstract:CONTEXT:Cancer is widely acknowledged to impact on the whole family. Yet, we do not know if there is benefit (or harm) from patient-family carer interventions in the context of cancer care. OBJECTIVES:To report a systematic search for and narrative review of patient-family carer interventions tested in the context of ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2011.03.013
更新日期:2012-01-01 00:00:00
abstract:CONTEXT:Evidence-based resource allocation is receiving increasing attention as we strive for equity, transparency, and cost-effectiveness across health care. In the context of finite resources, which of our patients with terminal illness should be prioritized for urgent palliative care? OBJECTIVES:To develop the scor...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.08.009
更新日期:2020-01-01 00:00:00
abstract::Brief symptom instruments are designed to assess symptoms while maintaining low respondent burden, but they may omit important information. Our objective was to determine whether a representative brief symptom instrument effectively captures the full symptom experience of older adults with advanced diseases. In this c...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2005.05.014
更新日期:2006-01-01 00:00:00
abstract::Pruritus is a common opioid side effect and can be so severe that opioid therapy must be modified or abandoned. Antihistamines, opioid antagonists, and propofol have been proposed as treatment options, but none is universally effective. The use of intranasal butorphanol, an opioid agonist-antagonist, for pruritus has ...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/0885-3924(96)00154-6
更新日期:1996-10-01 00:00:00
abstract::Patients with advanced cancer often do not receive high-quality pain and symptom management or support with coordination of care, communication, and decision making. Implementing quality indicators that are reflective of the scope of care, feasible to implement, and supported by evidence might help to identify areas a...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2009.04.024
更新日期:2009-12-01 00:00:00
abstract::The influence of personality characteristics on how patients cope with various challenges at the end of life has not been extensively studied. In order to examine the association between end-of-life experience and neuroticism (defined within the personality literature as a trait tendency to experience psychological di...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2006.05.011
更新日期:2006-10-01 00:00:00
abstract::The HIV/AIDS epidemic in boys and men with hemophilia began in the early 1980s with the puzzling occurrence of systemic illness and fatal opportunistic infections in patients who had received plasma-derived clotting factor concentrates. This brief narrative describes one physician's experience in caring for patients w...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.02.017
更新日期:2013-07-01 00:00:00
abstract:CONTEXT:Pain is common among patients with advanced cancer despite the dissemination of clinical pain care guidelines. OBJECTIVES:We sought to assess the quality of pain care among patients with advanced disease. METHODS:We reviewed the records of 85 adult ambulatory patients with advanced breast, lung, and gastroint...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.06.022
更新日期:2012-06-01 00:00:00
abstract::Assessment of patient quality of life (QOL) requires balancing the details provided by multi-item assessments with the reduced burden of single-item assessments. In this project, we investigated the psychometric properties of single-item Linear Analog Scale Assessments (LASAs) for patients with newly diagnosed high-gr...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.01.016
更新日期:2007-12-01 00:00:00
abstract::The United States Agency for Health Care Policy and Research (AHCPR) Acute Pain Management Guidelines were written to provide a scientific basis for practice. Educational programs designed to promote use of the guidelines may change practice in community hospitals. This article describes the development and implementa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(98)00142-0
更新日期:1999-04-01 00:00:00
abstract::Palliative care development and services were reviewed in the region represented by the six members of the Middle East Cancer Consortium: Cyprus, Egypt, Israel, Jordan, the Palestinian Authority, and Turkey. The multimethod review synthesized evidence from ethnographic field visits to inpatient units, home care hospic...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.02.014
更新日期:2009-03-01 00:00:00
abstract:CONTEXT:In the U.S., patients with advanced cancer who are dehydrated or have decreased oral intake almost always receive parenteral hydration in acute care facilities but rarely in the hospice setting. OBJECTIVES:To describe the meaning of hydration for terminally ill cancer patients in home hospice care and for thei...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2011.06.016
更新日期:2012-05-01 00:00:00
abstract:CONTEXT:Socioeconomic status (SES) is an important determinant of disparities in health services and may affect the utilization of hospice care services during end-of-life (EOL) treatment in patients with cancer. However, previous studies evaluating the association between SES and utilization of hospice care services a...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.03.015
更新日期:2020-08-01 00:00:00
abstract::The relationship of trauma history to physical and emotional functioning in primary care pain patients was examined. Data were drawn from a mailed screening questionnaire for a larger study designed to evaluate an intervention for improving pain management in primary care. Results indicated that 50.4% of the pain pati...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(02)00646-2
更新日期:2003-03-01 00:00:00
abstract::Concerns have been voiced about financial pressures faced by rural hospices, because of possible implications for hospice access in rural areas. To assess whether financial performance differs between existing urban and rural hospices, we used the 2003 California Office of Statewide Health Planning and Development sur...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.01.008
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:Decisional regret is an indicator of satisfaction with the treatment decision and can help to identify those patients who need more support and evaluate the efficacy of decision support interventions. The objectives of this study are, 1) to evaluate the psychometric properties of the Decision Regret Scale an...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2018.11.017
更新日期:2019-04-01 00:00:00
abstract:CONTEXT:Assessment and response to patients' spiritual concerns are crucial components of high-quality supportive care. Better measures of spiritual needs across the cultural spectrum may help direct necessary interventions. OBJECTIVES:The objective of this study was to assess spiritual needs in a racially/ethnically ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2017.08.009
更新日期:2018-01-01 00:00:00
abstract:CONTEXT:Family members of seriously ill patients experience significant burden as they advocate with providers and participate in key decisions for loved ones. Most assessments focus on patient experience, yet family members' own quality of experience is central to comprehensive care. OBJECTIVES:This study validated a...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2014.04.006
更新日期:2014-12-01 00:00:00
abstract::To improve assessment and management of pain in nonverbal older adults with dementia, an effective means of recognizing and evaluating pain in this vulnerable population is needed. The purpose of this review is to critically evaluate the existing tools used for pain assessment in this population to provide recommendat...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2005.07.001
更新日期:2006-02-01 00:00:00
abstract:CONTEXT:Recent analyses of Medicare data show decreases over time in intensity of end-of-life care. Few studies exist regarding trends in intensity of end-of-life care for those under 65 years of age. OBJECTIVES:To examine recent temporal trends in place of death, and both hospital and intensive care unit (ICU) utiliz...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.08.032
更新日期:2018-01-01 00:00:00
abstract::Dexamethasone is likely to play a role in the etiology of hiccups in patients receiving cisplatin-based regimens. Two hundred seventy-seven patients received three doses of ondansetron 8mg intravenously (IV) at 4hour intervals plus dexamethasone 20mg IV from the start of chemotherapy, followed by dexamethasone 5mg IV ...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpainsymman.2005.08.008
更新日期:2005-10-01 00:00:00
abstract::The purpose of this randomized controlled community trial is to evaluate the effects of a community intervention utilizing opinion leaders and educational strategies on the cancer pain management knowledge, attitudes, and the practices of physicians and nurses, and cancer pain reported by patients. Six Minnesota commu...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0885-3924(96)00275-8
更新日期:1997-04-01 00:00:00
abstract:CONTEXT:Development of pharmacological and behavioral interventions for cancer-related fatigue (CRF) requires adequate measures of this symptom. A guidance document from the Food and Drug Administration offers criteria for the formulation and evaluation of patient-reported outcome measures used in clinical trials to su...
journal_title:Journal of pain and symptom management
pub_type: 指南,杂志文章,评审
doi:10.1016/j.jpainsymman.2010.02.006
更新日期:2010-06-01 00:00:00
abstract:CONTEXT:Knowledge is limited regarding pain assessment and management practices, as well as pain-related outcomes in hospice care. OBJECTIVES:To generate national estimates of pain assessment and management practices and outcomes of pain control among patients 65 years or older receiving hospice care in the U.S. and i...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2016.05.020
更新日期:2016-11-01 00:00:00
abstract:CONTEXT:Hospitalized patients with advanced cancer often face complex, preference-sensitive decisions. How clinicians and patients engage in shared decision-making during goals-of-care discussions is not well understood. OBJECTIVE:The objective of this study was to explore decision-making by patients and clinicians du...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.05.002
更新日期:2019-08-01 00:00:00
abstract::This report describes an 18-month project to make acute and cancer pain management an institutional priority in Southeastern Wisconsin health-care facilities. Facility-based teams, each of which included a nurse in a leadership position, were recruited to participate in a project based on the Cancer Pain Role Model Pr...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/S0885-3924(97)00224-8
更新日期:1997-11-01 00:00:00
abstract:CONTEXT:Thirst is a prevalent distressing symptom often reported by patients in the intensive care unit (ICU). Little is known about the association of thirst with delirium. OBJECTIVE:We aimed to investigate the relationship between thirst and delirium. METHODS:This retrospective cross-sectional study enrolled 401 pa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.02.022
更新日期:2019-06-01 00:00:00
abstract::Patients and families facing serious illness often want and need their clinicians to help guide medical decision making by offering a recommendation. Yet clinicians worry that recommendations are not compatible with shared decision making and feel reluctant to offer them. We describe an expert approach to formulating ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.12.488
更新日期:2018-04-01 00:00:00